Breathing difficulties and snoring are now being seriously considered as a cause of ADHD behavioural patterns.
Unfortunately, most parents don't even realize their child has problems breathing properly at night - and even if they did, they wouldn't have thought it was anything to do with hyperactivity or learning problems.
But scientists have discovered that sleep-disordered breathing (SDB), as it's known, may be the unsuspected cause of ADHD-spectrum problems - or it may be misdiagnosed as ADHD.
Symptoms of ADHD tend to appear early on in a child's life, and the chances are that there is an associated breathing problem that goes with it.
Scientists have discovered that children whose breathing problems are tackled early also go on to enjoy greater academic success. In one study of 19 children aged between six and 16, those with breathing problems also had lower IQ levels than children who were able to breathe properly at night.
In another study, brain scans of children who had breathing problems revealed neural injury in the area associated with learning and memory.
Often, neither doctors nor parents realize that ADHD may be a wrong diagnosis, and that the underlying problem relates to breathing problems. Once these are treated and cleared, the supposed ADHD problems also go away.
Snoring is the most obvious sign of a breathing problem, and it affects around 1 in 5 children. However, this is for mild cases where the child snores around three times a week. Severe cases, where the child snores frequently every night, affects just 1 in 20.
Other signs might include laboured breathing, or snorting and gasping; others again may adopt unusual sleeping positions, or suffer from nightmares of drowning or choking.
If your child has SDB and ADHD, the choices offered by medicine are limited. At one extreme there's surgery to remove the tonsils and adenoids, but this often doesn't work on its own. Another option is 'continuous positive airway pressure therapy', which involves an electronic device that delivers constant air pressure via a nasal mask.
(Source: Journal of the American Medical Association, 2007; 297: 2681-2).
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